The Effect of Alcohol Consumption on Clinical Outcomes and Structural Damage in Patients with Axial Spondyloarthritis: A Systematic Literature Review and Meta-Analysis

Sinead Maguire¹, Nigil Haroon², Robert Inman³, Melanie Anderson⁴, Evelyne Gendron⁵ and Sindhu R. Johnson⁶, ¹University of Toronto, University Health Network, Schroeder Arthritis Institute, Department of Rheumatology, Toronto, Canada, ²Department of Medicine/Rheumatology, University Health Network, Schroeder Arthritis Institute, University of Toronto, Toronto, ON, Canada, ³University Health Network, Toronto, ON, Canada, ⁴The Institute for Education Research, Library and Information Services, University Health Network, Toronto, ON, Canada, ⁵University of Toronto, University Health Network, Schroeder Arthritis Institute, Department of Rheumatology, Quebec City, QC, Canada, ⁶University of Toronto, Toronto, Canada

Meeting: ACR Convergence 2024

Keywords: Ankylosing spondylitis (AS), Back pain, Damage Index, Disease Activity, spondyloarthritis

Session Information

Date: Saturday, November 16, 2024

Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Axial spondyloarthritis (axSpA) is a chronic progressive inflammatory disease characterized by the involvement of the axial skeleton. Alcohol consumption (AC) is a modifiable lifestyle factor with potential anti-inflammatory properties. Studies on the effects of alcohol in axSpA have been limited, with divergent conclusions. We aimed to systematically review the effects of alcohol consumption on disease-specific outcomes in axSpA.

Methods: A systematic review of observational studies on axSpA and AC was conducted. Multiple electronic databases were searched for keywords. Two investigators reviewed articles to assess for inclusion eligibility. The Joanna Briggs Institute Critical Appraisal checklist was employed to evaluate the risk of bias. Standardized mean differences (SMD) were used to synthesize the data and I² was used to ascertain heterogeneity.

Results: Search strategy identified 703 records; 13 articles were assessed for eligibility. Five studies with a total of 3858 axSpA patients were included. Compared to non-consumers, axSpA patients who consumed alcohol had lower BASDAI (SMD -0.19, 95% CI -0.37 to -0.02, I²=72.5%), lower spinal pain (SMD -0.17, 95% CI -0.24 to -0.09, I² = 0%) and a non-significant trend towards lower ASDAS (SMD -0.19, 95% CI -0.39 to 0.00, I² = 36%) (Figure 1). One cohort study on the spinal radiographic progression indicated greater radiographic progression among consumers (SMD 0.35, 95% CI 0.08 to 0.62).

Conclusion: AC appears to be associated with lower disease activity and spinal pain. Further longitudinal cohort studies with standardized measures for AC are warranted to assess the direction of alcohol’s effect on structural damage progression.

Abbreviations: BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; ASDAS: Ankylosing Spondylitis Disease Activity Score; SMD; Standardized Mean Difference.

Disclosures: S. Maguire: None; N. Haroon: AbbVie, 2, Novartis, 2, UCB Pharma, 2; R. Inman: Abbvie, 2, Janssen, 2, novartis, 2, 5, UCB, 2; M. Anderson: None; E. Gendron: None; S. Johnson: None.

To cite this abstract in AMA style:

Maguire S, Haroon N, Inman R, Anderson M, Gendron E, Johnson S. The Effect of Alcohol Consumption on Clinical Outcomes and Structural Damage in Patients with Axial Spondyloarthritis: A Systematic Literature Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/the-effect-of-alcohol-consumption-on-clinical-outcomes-and-structural-damage-in-patients-with-axial-spondyloarthritis-a-systematic-literature-review-and-meta-analysis/. Accessed .

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